Ophthalmologic information processing apparatus, ophthalmologic system, ophthalmologic information processing method, and recording medium

ABSTRACT

An ophthalmologic information processing apparatus includes an analyzer, a storage unit, a region editing unit, and a display controller. The analyzer is configured to analyze data of a subject&#39;s eye optically acquired by projecting light onto the subject&#39;s eye, and to specify a lesion region in the subject&#39;s eye. The storage unit stores image data of the subject&#39;s eye. The region editing unit is configured to specify a changed region by changing the lesion region based on operation information corresponding to an operation content on an operating unit. The display controller is configured to cause an image of the subject&#39;s eye to be displayed on a display means based on the image data stored in the storage unit, and to cause a region corresponding to the changed region in the image of the subject&#39;s eye to be displayed so as to be identifiable.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a continuation application of InternationalPatent Application No. PCT/JP2018/038124, filed Oct. 12, 2018, whichclaims priority to Japanese Patent Application No. 2017-225892, filedNov. 24, 2017. The contents of these applications are incorporatedherein by reference in their entirety.

FIELD

The disclosure relates to an ophthalmologic information processingapparatus, an ophthalmologic system, an ophthalmologic informationprocessing method, and a program.

BACKGROUND

Age-related macular degeneration (AMD) is one of the causative diseasesof visual disturbance. AMD is a disease in which a macular region isimpaired directly or indirectly by aging. AMD is classified intoexudative age-related macular degeneration (exudative AMD) and atrophicage-related macular degeneration (atrophic AMD). Exudative AMD is adisease in which a retina is damaged by invasion of choroidalneovascularization from the choroid to the lower layer of retinalpigment epithelium layer (hereinafter, RPE) or invasion of choroidalneovascularization between the retina and the RPE. Atrophic AMD is adisease in which the retina is damaged by gradual atrophy of the RPE andvision is gradually decreased.

Photo dynamic therapy (PDT), drug therapy, laser coagulation and thelike are known as effective treatments of exudative AMD. On the otherhand, effective treatment for atrophic AMD is not well established atpresent. Therefore, understanding the state of atrophic AMD is extremelyimportant.

In atrophic AMD, so-called geographic atrophy (GA) is found in apredetermined region centered on a fovea. GA is specified from fundusimages, fluorescein fluorescence fundus angiograms, fundusautofluorescnece inspection images, or the like, or GA is specified fromtomographic images of the retina obtained using optical coherencetomography (for example, U.S. Unexamined Patent Application PublicationNo. 2015/0201829, Japanese Unexamined Patent Publication No.2015-136626, Japanese Unexamined Patent Publication No. 2016-107148).The state of atrophic AMD can be understood by observing the specifiedGA (for example, Japanese Unexamined Patent Application Publication(Translation of PCT Application) No. 2014-505552).

SUMMARY

In order to understand the state of atrophic AMD (age-related maculardegeneration), observing morphology (form) (shape, size) or distributionof the region (geographic atrophy region) with geographic atrophy iseffective. However, in the conventional techniques, detection accuracyof a lesion region such as an atrophy region is not sufficient. Thereby,in some cases, it was difficult for a doctor or the like to make anaccurate diagnosis for a patient.

According to some embodiments of the present invention, a new techniquefor providing information for doctors or the like to make accuratediagnosis for patients even when the detection accuracy of the lesionregion is not sufficient can be provided.

One aspect of some embodiments is an ophthalmologic informationprocessing apparatus, including: an analyzer configured to analyze dataof a subject's eye optically acquired by projecting light onto thesubject's eye, and to specify a lesion region in the subject's eye; astorage unit storing image data of the subject's eye; a region editingunit configured to specify a changed region by changing the lesionregion based on operation information corresponding to an operationcontent on an operating unit; and a display controller configured tocause an image of the subject's eye to be displayed on a display meansbased on the image data stored in the storage unit, and to cause aregion corresponding to the changed region in the image of the subject'seye to be displayed so as to be identifiable.

Another aspect of some embodiments is an ophthalmologic system,including: a data acquisition unit configured to acquire the data byscanning the subject's eye using optical coherence tomography; thedisplay means; and the ophthalmologic information processing apparatusdescribed above.

Further, another aspect of some embodiments is an ophthalmologicinformation processing method, including: an analysis step of analyzingdata of a subject's eye optically acquired by projecting light onto thesubject's eye, and of specifying a lesion region in the subject's eye; aregion editing step of specifying a changed region by changing thelesion region based on operation information corresponding to anoperation content on an operating unit; and a display step of causing animage of the subject's eye to be displayed on a display means based onimage data of the subject's eye, and of causing a region correspondingto the changed region in the image of the subject's eye to be displayedso as to be identifiable.

Further, another aspect of some embodiments is a recording mediumsstoring program of causing a computer to execute each step of theophthalmologic information processing method described above.

BRIEF EXPLANATION OF THE DRAWINGS

FIG. 1 is a schematic diagram illustrating an example of a configurationof an ophthalmologic system according to embodiments.

FIG. 2 is a schematic diagram illustrating an example of a configurationof an ophthalmologic apparatus according to the embodiments.

FIG. 3 is a schematic diagram illustrating an example of theconfiguration of the ophthalmologic information processing apparatusaccording to the embodiments.

FIG. 4 is a schematic diagram illustrating an example of theconfiguration of the ophthalmologic information processing apparatusaccording to the embodiments.

FIG. 5 is a schematic diagram illustrating an example of an operationflow of the ophthalmologic information processing apparatus according tothe embodiments.

FIG. 6 is a schematic diagram for explaining an operation of theophthalmologic information processing apparatus according to theembodiments.

FIG. 7 is a schematic diagram for explaining an operation of theophthalmologic information processing apparatus according to theembodiments.

FIG. 8 is a schematic diagram illustrating an example of an operationflow of the ophthalmologic information processing apparatus according tothe embodiments.

FIG. 9 is a schematic diagram for explaining an operation of theophthalmologic information processing apparatus according to theembodiments.

FIG. 10 is a schematic diagram for explaining an operation of theophthalmologic information processing apparatus according to theembodiments.

FIG. 11A is a schematic diagram for explaining an operation of theophthalmologic information processing apparatus according to theembodiments.

FIG. 11B is a schematic diagram for explaining an operation of theophthalmologic information processing apparatus according to theembodiments.

FIG. 12 is a schematic diagram for explaining an operation of theophthalmologic information processing apparatus according to theembodiments.

FIG. 13 is a schematic diagram for explaining an operation of theophthalmologic information processing apparatus according to theembodiments.

FIG. 14 is a schematic diagram for explaining an operation of theophthalmologic information processing apparatus according to theembodiments.

FIG. 15 is a schematic diagram for explaining an operation of theophthalmologic information processing apparatus according to theembodiments.

FIG. 16 is a schematic diagram for explaining an operation of theophthalmologic information processing apparatus according to theembodiments.

FIG. 17 is a schematic diagram illustrating an example of aconfiguration of the ophthalmologic information processing apparatusaccording to a modification example of the embodiments.

FIG. 18 is a schematic diagram for explaining an operation of theophthalmologic information processing apparatus according to amodification example of the embodiments.

FIG. 19 is a schematic diagram for explaining an operation of theophthalmologic information processing apparatus according to amodification example of the embodiments.

FIG. 20 is a schematic diagram illustrating an example of an operationflow of the ophthalmologic information processing apparatus according toa modification example of the embodiments.

FIG. 21 is a schematic diagram illustrating an example of theconfiguration of the ophthalmologic apparatus according to amodification example of the embodiments.

DETAILED DESCRIPTION

Referring now to the drawings, exemplary some embodiments of anophthalmologic information processing apparatus, an ophthalmologicsystem, an ophthalmologic information processing method, a program, anda recording medium according to some embodiments of the presentinvention are described below. Any of the contents of the documentscited in the present specification and arbitrary known techniques may beapplied to the embodiments below.

An ophthalmologic system according to the embodiments includes anophthalmologic information processing apparatus. An ophthalmologicinformation processing method according to the embodiments is performedby the ophthalmologic information processing apparatus. Theophthalmologic information processing method according to theembodiments can be executed by a computer according to a program.

The ophthalmologic information processing apparatus according to theembodiments can perform predetermined analysis processing andpredetermined display processing on data of a subject's eye opticallyacquired using the ophthalmologic apparatus. The analysis processingincludes processing for specifying a lesion region in the subject's eye.The display processing includes processing for displaying the specifiedlesion region so as to be identifiable. Hereinafter, a case will bedescribed in which a geographic atrophy region in the fundus is mainlyspecified as a lesion region, but embodiments are not limited thereto.

The ophthalmologic apparatus optically acquires a data of a subject'seye by projecting light onto the subject's eye. Hereinafter, a case willbe described in which the ophthalmologic apparatus acquires data of thesubject's eye using optical coherence tomography (OCT), but theophthalmologic apparatus according to the embodiments is not limitedthereto. The ophthalmologic apparatus according to some embodiments hasthe function of acquiring a front image of the fundus of the subject'seye. Examples of the ophthalmologic apparatus having the function ofacquiring the front image of the fundus of the subject's eye include anOCT apparatus, a fundus camera, a scanning laser ophthalmoscope (SLO), aslit lamp microscope, a surgical microscope, and the like. Theophthalmologic apparatus according to some embodiments has the functionof measuring optical characteristics of the subject's eye. Examples ofthe ophthalmologic apparatus having the function of measuring opticalcharacteristics of the subject's eye include a refractometer, akeratometer, a tonometer, a wave front analyzer, a specular microscope,a perimeter, and the like. The ophthalmologic apparatus according tosome embodiments has the function of a laser treatment apparatus usedfor laser therapy.

[Ophthalmologic System]

FIG. 1 shows a block diagram of an example of the configuration of theophthalmologic system according to the embodiments. The ophthalmologicsystem 1 according to the embodiments includes an ophthalmologicapparatus 10, an ophthalmologic information processing apparatus(ophthalmologic image processing apparatus, ophthalmologic analysisapparatus) 100, an operating apparatus 180, and a display apparatus 190.

The ophthalmologic apparatus 10 optically acquires the data of thefundus of the subject's eye by projecting light onto the subject's eye.The ophthalmologic apparatus 10 optically acquires the data of thefundus of the subject's eye by scanning the fundus of the subject's eye.For example, the ophthalmologic apparatus 10 acquires three-dimensionalOCT data of the fundus of the subject's eye using OCT. Theophthalmologic apparatus 10 can obtain an image of the fundus of thesubject's eye from the acquired data of the subject's eye. The images ofthe fundus include a tomographic image of the fundus, and a front imageof the fundus. Examples of the tomographic image of the fundus include aB scan image, and the like. Examples of the front image of the fundusinclude a C scan image, a shadowgram, a projection image, and the like.The ophthalmologic apparatus 10 sends the acquired data of the subject'seye to the ophthalmologic information processing apparatus 100.

In some embodiments, the ophthalmologic apparatus 100 and theophthalmologic information processing apparatus 100 are connected via adata communication network. The ophthalmologic information processingapparatus 100 according to some embodiments receives data from one of aplurality of ophthalmologic apparatuses 10 selectively connected via thedata communication network.

The ophthalmologic information processing apparatus 100 specifies ageographic atrophy region (atrophy region) by analyzing the acquireddata of the subject's eye, and causes the geographic atrophy region inthe front image or the tomographic image of the fundus to be displayedon the display apparatus 190 so as to be identifiable. Theophthalmologic information processing apparatus 100 can perform changingprocessing of the specified geographic atrophy region based on anoperation content on the operating apparatus 180 described later by theuser. Examples of the changing processing of the geographic atrophyregion include addition of a geographic atrophy region, deletion of partor whole of a geographic atrophy region, change of the shape or the sizeof the specified geographic atrophy region, or the like. In someembodiments, the user changes the geographic atrophy region by operatingthe operating apparatus 180 while referring to a fluoresceinfluorescence fundus angiogram or the like. The ophthalmologicinformation processing apparatus 100 can perform the followingprocessing by setting a region in which the changing processingdescribed above has been performed on the specified geographic atrophyregion as a new geographic atrophy region.

The ophthalmologic information processing apparatus 100 causes a regioncorresponding to the geographic atrophy region in the front image of thefundus formed from the acquired data of the subject's eye to behighlighted (displayed in highlighted manner). The ophthalmologicinformation processing apparatus 100 according to some embodiments formsthe front image of the fundus from the acquired data of the subject'seye, performs position matching between the formed front image and thespecified geographic atrophy region, and causes the front image of thefundus, on which the image representing the geographic atrophy region isoverlaid, to be displayed, the image having been performed positionmatching.

The ophthalmologic information processing apparatus 100 causes theregion corresponding to the geographic atrophy region in the tomographicimage of the fundus formed from the acquired data of the subject's eyeto be highlighted. The ophthalmologic information processing apparatus100 according to some embodiments forms the tomographic image of thefundus from the acquired data of the subject's eye, performs positionmatching between the formed tomographic image and the specifiedgeographic atrophy region, and causes the tomographic image of thefundus, on which the image representing the geographic atrophy region isoverlaid, to be displayed, the image having been performed positionmatching.

The operating apparatus 180 and the display apparatus 190 provide thefunction for exchanging information between the ophthalmologicinformation processing apparatus 100 and the user, such as displayinginformation, inputting information, and inputting operationinstructions, as a user interface unit. The operating apparatus 180includes an operating device such as a lever, a button, a key, andpointing device. The operating apparatus 180 according to someembodiments includes a microphone for inputting information using sound.The display apparatus 190 includes a display device such as a flat-paneldisplay. In some embodiments, the functions of the operating apparatus180 and the display apparatus 190 are realized using a device in which adevice having an input function such as a touch panel display and adevice having a display function are integrated. In some embodiments,the operating apparatus 180 and the display apparatus 190 include agraphical user interface (GUI) for inputting and outputting information.

[Ophthalmologic Apparatus]

FIG. 2 shows a block diagram of an example of the configuration of theophthalmologic apparatus 10 according to the embodiments.

The ophthalmologic apparatus 10 includes an optical system for acquiringOCT data of the subject's eye. The ophthalmologic apparatus 10 has afunction of performing swept source OCT, but the embodiments are notlimited to this. For example, the type of OCT is not limited to sweptsource OCT, and it may be the spectral domain OCT or the like. The sweptsource OCT is a technique that splits light from a wavelength sweep type(i.e., a wavelength scanning type) light source into measurement lightand reference light; superposes the measurement light returning from theobject to be measured with the reference light to generate interferencelight; detects the interference light with a balanced photodiode or thelike; and applies the Fourier transform etc. to the detection dataacquired through the tuning of wavelengths and the scanning of themeasurement light to form an image. The spectral domain OCT is atechnique that splits light from a low coherence light source intomeasurement light and reference light; superposes the measurement lightreturning from the object to be measured with the reference light togenerate interference light; detects the spectral distribution of theinterference light with a spectrometer; and applies the Fouriertransform etc. to the detected spectral distribution to form an image.

The ophthalmologic apparatus 10 includes a controller 11, a dataacquisition unit 12, an image forming unit 13, and a communication unit14.

The controller 11 controls each part of the ophthalmologic apparatus 10.In particular, the controller 11 controls the data acquisition unit 12,the image forming unit 13, and the communication unit 14.

The data acquisition unit 12 acquires data (three-dimensional OCT data)of the subject's eye by scanning the subject's eye using OCT. The dataacquisition unit 12 includes an interference optical system 12A and ascan optical system 12B.

The interference optical system 12A splits light from the light source(wavelength sweep type light source) into measurement light andreference light, makes returning light of the measurement light throughthe subject's eye and the reference light having traveled through areference optical path interfere with each other to generateinterference light, and detects the interference light. The interferenceoptical system 12A includes at least a fiber coupler and a lightreceiver such as a balanced photodiode. The fiber coupler splits thelight from the light source into the measurement light and the referencelight, and makes returning light of the measurement light through thesubject's eye and the reference light having traveled through areference optical path interfere with each other to generateinterference light. The light receiver detects the interference lightgenerated by the fiber coupler. The interference optical system 12A mayinclude the light source.

The scan optical system 12B changes an incident position of themeasurement light on the fundus of the subject's eye by deflecting themeasurement light generated by the interference optical system 12A,under the control of the controller 11. The scan optical system 12Bincludes, for example, an optical scanner disposed at a positionoptically conjugate with a pupil of the subject's eye. The opticalscanner includes, for example, a galvano mirror that scans with themeasurement light in the horizontal direction, a galvano mirror thatscans with the measurement light in the vertical direction, and amechanism that independently drives the galvano mirrors. With this, itis possible to scan the measurement light in an arbitrary direction inthe fundus plane.

A detection result (detection signal) of the interference light obtainedby the interference optical system 12A is an interference signalrepresenting the spectrum of the interference light.

The image forming unit 13 forms image data of a tomographic image of thefundus of the subject's eye based on the data of the subject's eyeacquired by the data acquisition unit 12, under the control of thecontroller 11. This processing includes noise removal (noise reduction),filtering, fast Fourier transform (FFT), and the like. The image dataacquired in this manner is a data set including a group of image dataformed by imaging the reflection intensity profiles of a plurality of Alines. Here, the A lines are the paths of the measurement light in thesubject's eye. In order to improve the image quality, it is possible torepeatedly perform scan with the same pattern a plurality of times tocollect a plurality of data sets, and to compose (i.e., average) theplurality of data sets.

The image forming unit 13 can form a B scan image, a C scan image, aprojection image, a shadowgram, etc., by performing various renderingson the acquired three-dimensional OCT data. An image in an arbitrarycross section such as the B scan image or the C scan image is formed byselecting pixels (voxels) on a designated cross section from thethree-dimensional OCT data. The projection image is formed by projectingthe three-dimensional OCT data in a predetermined direction (Zdirection, depth direction, A scan direction). The shadowgram is formedby projecting a part of the three-dimensional OCT data (for example,partial data corresponding to a specific layer) in a predetermineddirection.

The ophthalmologic apparatus 10 according to some embodiments includes adata processor that performs various kinds of data processing (e.g.,image processing) and various kinds of analysis processing on the imageformed by the image forming unit 13. For example, the data processorperforms various correction processes such as brightness correction anddispersion correction of images. The data processor can form volume data(voxel data) of the subject's eye by performing known image processingsuch as interpolation processing for interpolating pixels betweentomographic images. In the case of displaying an image based on thevolume data, the data processor performs rendering processing on thevolume data so as to form a pseudo three-dimensional image viewed from aspecific line-of-sight direction.

Each of the controller 11 and the image forming unit 13 includes aprocessor. The processor includes, for example, a circuit(s) such as,for example, a CPU (central processing unit), a GPU (graphics processingunit), an ASIC (application specific integrated circuit), and a PLD(programmable logic device). Examples of PLD include a simpleprogrammable logic device (SPLD), a complex programmable logic device(CPLD), and a field programmable gate array (FPGA). The functions of theimage forming unit 13 are realized by an image forming processor. Insome embodiments, both of the functions of the controller 11 and theimage forming unit 13 are realized by a single processor. In someembodiments, in case that the ophthalmologic apparatus 10 includes thedata processor, the functions of the data processor are also realized bya processor.

The processor realizes, for example, the function according to theembodiments by reading out a computer program stored in a storagecircuit or a storage device and executing the computer program. At leasta part of the storage circuit or the storage apparatus may be includedin the processor. Further, at least a part of the storage circuit or thestorage apparatus may be provided outside of the processor.

The storage apparatus etc. stores various types of data. Examples of thedata stored in the storage apparatus etc. include data (measurementdata, photographic data, etc.) acquired by the data acquisition unit 12and information related to the subject and the subject's eye. Thestorage apparatus etc. may store a variety of computer programs and datafor the operation of each part of the ophthalmologic apparatus 10.

The communication unit 14 performs communication interface processingfor sending or receiving information with the ophthalmologic informationprocessing apparatus 100 under the control of the controller 11.

The ophthalmologic apparatus 10 according to some embodiments sends theimage data of the subject's eye formed by the image forming unit 13 tothe ophthalmologic information processing apparatus 100.

The ophthalmologic apparatus 10 according to some embodiments includes afundus camera for acquiring an image of the fundus of the subject's eye,a scanning laser ophthalmoscope for acquiring an image of the fundus ofthe subject's eye, or a slit lamp microscope. In some embodiments, thefundus image acquired by the fundus camera is a fluorescein fluorescencefundus angiogram or a fundus autofluorescence inspection image.

[Ophthalmologic Information Processing Apparatus]

FIGS. 3 and 4 show block diagrams of examples of the configuration ofthe ophthalmologic information processing apparatus 100 according to theembodiments. FIG. 3 shows a functional block diagram of theophthalmologic information processing apparatus 100. FIG. 4 shows afunctional block diagram of an analyzer 200 of FIG. 3.

The ophthalmologic information processing apparatus 100 according to theembodiments analyzes the data of the fundus of the subject's eyeacquired by the ophthalmologic apparatus 10 to specify a geographicatrophy region in the fundus. The ophthalmologic information processingapparatus 100 causes the specified geographic atrophy region in thefront image or the tomographic image of the fundus to be displayed onthe display apparatus 190 so as to be identifiable.

The ophthalmologic information processing apparatus 100 includes acontroller 110, an image forming unit 120, a data processor 130, and acommunication unit 140.

The image forming unit 120 forms a B scan image, a C scan image, aprojection image, a shadowgram, or the like from the three-dimensionalOCT data acquired by the ophthalmologic apparatus 10 under the controlof the controller 110. The image forming unit 120 can form the aboveimage in the same manner as the image forming unit 13.

The data processor 130 performs various kinds of data processing (e.g.,image processing) and various kinds of analysis processing on an imageformed by the image forming unit 120. For example, the data processor130 performs various correction processes such as brightness correctionand dispersion correction of images. The data processor 130 can formvolume data (voxel data) of the subject's eye by performing known imageprocessing such as interpolation processing for interpolating pixelsbetween tomographic images. In the case of displaying an image based onthe volume data, the data processor 130 performs rendering processing onthe volume data so as to form a pseudo three-dimensional image viewedfrom a specific line-of-sight direction.

The data processor 130 performs predetermined data processing on theformed image of the subject's eye. The processor 130 includes ananalyzer 200, a position matching processor 210, and a region editingunit 220.

The analyzer 200 performs predetermined analysis processing on the imagedata of the fundus of the subject's eye formed by the image forming unit120 (or the image data of the fundus of the subject's eye acquired bythe ophthalmologic apparatus 10). Examples of the analysis processingaccording to some embodiments include specifying processing of thegeographic atrophy region in the fundus, generating processing of thedistribution information of the geographic atrophy region, generatingprocessing of the morphology information of the geographic atrophyregion, generating processing of the distribution information of layerthickness in the fundus, and the like.

The analyzer 200 include a segmentation processor 201, a regionspecifying unit 202, a distribution information generator 203, amorphology information generator 204, and a layer thickness distributioninformation generator 205.

The segmentation processor 201 specifies a plurality of layer regions inthe A scan direction based on the data of the subject's eye acquired bythe ophthalmologic apparatus 10. The segmentation processor 201according to some embodiments analyzes the three-dimensional OCT data tospecify a plurality of partial data sets corresponding to a plurality oftissues of the subject's eye. The segmentation processing is imageprocessing for specifying specific tissues and/or tissue boundaries. Forexample, the segmentation processor 201 obtains the gradients of thepixel values (i.e., brightness values) in each A scan image included inthe OCT data, and specifies a position where the gradient value is largeto be a tissue boundary. Note that the A scan image is one-dimensionalimage data extending in the depth direction of the fundus. The depthdirection of the fundus is defined as, for example, the Z direction, theincident direction of the OCT measurement light, the axial direction,the optical axis direction of the interference optical system, or thelike.

In a typical example, the segmentation processor 201 specifies aplurality of partial data sets corresponding to a plurality of layertissues of the fundus by analyzing the three-dimensional OCT datarepresenting the fundus (the retina, the choroid, etc.) and the vitreousbody. Each partial data set is defined by the boundaries of the layertissue. Examples of the layer tissue specified as the partial data setinclude a layer tissue constituting the retina. Examples of the layertissue constituting the retina include the inner limiting membrane, thenerve fiber layer, the ganglion cell layer, the inner plexiform layer,the inner nuclear layer, the outer plexiform layer, the outer nuclearlayer, the external limiting membrane, the photoreceptor layer, theretinal pigment epithelium layer, and the like. The segmentationprocessor 201 can specify a partial data set corresponding to the Bruchmembrane, the choroid, the sclera, the vitreous body, or the like. Thesegmentation processor 201 according to some embodiments specifies apartial data set corresponding to the site of lesion. Examples of thesite of lesion include a detachment part, an edema, a bleeding site, atumor, a drusen, and the like.

The segmentation processor 201 according to some embodiments specifies,as the Bruch membrane, a layer tissue for a predetermined number ofpixels on the sclera side with respect to the RPE, and acquires, as thepartial data set of the Bruch membrane, the partial data setcorresponding to the layer tissue.

The region specifying unit 202 specifies a region corresponding to twolayer tissues for specifying the geographic atrophy region by analyzinga plurality of partial data sets of the layer tissues specified by thesegmentation processor 201. The region specifying unit 202 according tosome embodiments specifies a first region and a second region, the firstregion corresponding to a layer tissue on the sclera side with respectto a region corresponding to the Bruch membrane, the second regioncorresponding to a layer region from a region corresponding to the innerlimiting membrane to a region corresponding to the RPE. In someembodiments, the second region is a region corresponding to a layertissue on the cornea side from the region corresponding to the Bruchmembrane.

The distribution information generator 203 obtains a contrast ratio foreach A scan based on the pixel values in the first region and the secondregion which are specified by the region specifying unit 202, andgenerates two-dimensional distribution information of the contrast ratioin the fundus plane (plane orthogonal to the A scan direction). In someembodiments, the distribution information generator 203 generates thedistribution information of the ratio of the integrated value of thepixel values of the first region specified by the region specifying unit202 and the integrated value of the pixel values of the second regionspecified by the layer region specifying unit 202, for each A scan. Thedistribution information generator 203 according to some embodimentsobtains, as the contrast ratio, the ratio of the integrated value of thepixel values in the A scan direction of the second region to theintegrated value of the pixel values in the A scan direction of thefirst region, and generates the two-dimensional distribution informationof the obtained contrast ratio. The two-dimensional distributioninformation of the contrast ratio is hereinafter referred to as acontrast map.

The analyzer 200 specifies a position where the contrast ratio is large,as a position where signal components are attenuated due to thegeographic atrophy, in the contrast map generated by the distributioninformation generator 203. The analyzer 200 specifies the geographicatrophy region based on the specified position. For example, theanalyzer 200 specifies, as the geographic atrophy region, a regionincluding positions where the contrast ratio is equal to or larger thana predetermined threshold value, in the contrast map generated by thedistribution information generator 203. Techniques related to such amethod for specifying a geographic atrophy region are disclosed in U.S.Unexamined Patent application Publication No. 2015/0201829, JapaneseUnexamined Patent Application Publication No. 2015-136626, or JapaneseUnexamined Patent Application Publication No. 2016-107148.

The morphology information generator 204 generates morphologyinformation representing morphology of the specified geographic atrophyregion. Examples of the morphology information include the area of thegeographic atrophy region(s), the outer perimeter of the geographicatrophy region(s), and the like. The morphology information generator204 can obtain the area of the geographic atrophy region(s) or the outerperimeter of the geographic atrophy region(s) by applying a known methodto the image in which the geographic atrophy region(s) is(are) depicted.The morphology information generator 204 according to some embodimentsgenerates the morphology information for each of the specifiedgeographic atrophy regions. The morphology information generator 204according to some embodiments generates, as the morphology information,the total value of morphological parameters (areas, outer perimeters)for each of the specified geographic atrophy regions. In someembodiments, the morphology information includes the number of thespecified geographic atrophy regions.

The layer thickness distribution information generator 205 specifies athickness in the A scan direction of each of the layer tissues byanalyzing the partial data sets of the plurality of the layer tissuesspecified by the segmentation processor 201, and generates thetwo-dimensional distribution information of the layer thickness of theeach layer in the fundus plane. The layer thickness distributioninformation generator 205 according to some embodiments generates thetwo-dimensional distribution information (distribution information ofthe plane orthogonal to the A scan direction) of the layer thickness ofthe one or more layer tissues designated using the operating apparatus180. The layer thickness distribution information generator 205according to some embodiments generates the two-dimensional distributioninformation of the layer thickness of at least one of the inner limitingmembrane, the nerve fiber layer (NFL), the ganglion cell layer (GCL),the inner plexiform layer (IPL), the inner nuclear layer (INL), theouter plexiform layer (OPL), the outer nuclear layer (ONL), the externallimiting membrane (ELM), the retinal pigment epithelium layer (RPE), thechoroid, the sclera, and the choroidal-scleral interface (CSI), or twoor more adjacent layers.

The position matching processor 210 performs position matching(registration) between a front image of the fundus formed by the imageforming unit 120 and an image representing the geographic atrophy regionspecified by the analyzer 200. The position matching processor 210performs position matching between the tomographic image of the fundusformed by the image forming unit 120 and the image representing thegeographic atrophy region specified by the analyzer 200.

The position matching processing includes, for example, processing fordetecting characteristic sites from the both images and processing forperforming position matching of the both images on the base of the bothcharacteristic sites. In some embodiments, the position matchingprocessing includes processing for specifying a position in the imagerepresenting the geographic atrophy region in the front image or thetomographic image using position information of the geographic atrophyregion in the front image or the tomographic image of the fundus andprocessing for performing position matching of the image representingthe specified geographic atrophy region with respect to the front imageor the tomographic image. The position matching processor 210 canperform position matching using known processing such as affinetransformation for performing enlargement, reduction, rotation, or thelike of the image.

The position matching processor 210 performs position matching betweenthe tomographic image of the fundus formed by the image forming unit 120and the image representing the geographic atrophy region specified bythe analyzer 200.

The region editing unit 220 performs the changing processing of thegeographic atrophy region specified by the analyzer 200 as describedabove. Examples of the changing processing of the geographic atrophyregion include addition of a geographic atrophy region, deletion of partor whole of a geographic atrophy region, change of the shape or the sizeof the specified geographic atrophy region, or the like. The regionediting unit 220 performs the changing processing of the geographicatrophy region based on the operation information corresponding to theoperation content on the operating apparatus 180 by the user. The regionediting unit 220 according to some embodiments performs the changingprocessing of the geographic atrophy region based on a control contentfrom a controller 110.

The region editing unit 220 specifies a changed region by changing thegeographic atrophy region specified by the analyzer 200, based on theoperation information corresponding to the operation content on theoperating apparatus 180. In some embodiments, the region editing unit220 changes region specifying information for specifying a position or ashape of the geographic atrophy region obtained by performing analysisprocessing by the analyzer 200, based on the operation informationdescribed above, and stores the changed region specifying information ina storage unit 112. Thereby, the ophthalmologic information processingapparatus 100 can cause a region corresponding to the changed region inthe image of the subject's eye to be displayed so as to be identifiable.

The region editing unit 220 can specify the changed region by changingthe shape of the geographic atrophy region specified by the analyzer200, based on the operation information from the operating apparatus180. Thereby, a doctor or the like can change the shape of thegeographic atrophy region specified by the analyzer 200 while referringto information obtained from another ophthalmologic apparatus, and canobserve the morphology or the distribution of the geographic atrophyregion in detail from the obtained changed region.

The region editing unit 220 can specify the changed region by adding aregion designated based on the operation information from the operatingapparatus 180 to the geographic atrophy region specified by the analyzer200. Thereby, a doctor or the like newly add the geographic atrophyregion specified by the analyzer 200 while referring to informationobtained from another ophthalmologic apparatus, and the morphology orthe distribution of the geographic atrophy region can be observed indetail from the obtained changed region.

The region editing unit 220 can specify the changed region by deleting aregion, which is designated based on the operation information from theoperating apparatus 180, from the geographic atrophy region specified bythe analyzer 200. Thereby, a doctor or the like can delete a desiredregion from geographic atrophy region specified by the analyzer 200while referring to information obtained from another ophthalmologicapparatus, and can observe the morphology or the distribution of thegeographic atrophy region in detail from the obtained changed region.

The analyzer 200 according to some embodiments newly specifies thegeographic atrophy region in the subject's eye by performing an analysisagain, to which analysis condition different from analysis conditionbefore changing has been applied, on the changed region changed by theregion editing unit 220. The ophthalmologic information processingapparatus 100 causes a region corresponding to the geographic atrophyregion specified newly by performing the analysis again by the analyzer200 to be displayed on the display apparatus 190 so as to beidentifiable. For example, the analyzer 200 specifies a new geographicatrophy region by analyzing the changed region, which is obtained byperforming the changing processing described above on the geographicatrophy region specified under a first analysis condition, under asecond analysis condition different from the first analysis condition.In some embodiments, the analysis condition can be changed by operatingon the operating apparatus 180 by the user. In some embodiments, underthe first analysis condition, the geographic atrophy region is specifiedby applying a first threshold value to a contrast map generated by thedistribution information generator 203. Further, under the secondanalysis condition, the geographic atrophy region is specified byapplying a second threshold value different from the first thresholdvalue to the contrast map generated by the distribution informationgenerator 203. The second threshold value may be lower than the firstthreshold value. For example, the controller 110 may cause an operationobject operable using the operating apparatus 180 to be displayed on thedisplay apparatus 190, and may specify the geographic atrophy region byapplying a threshold value corresponding to an operation content on theoperation object. Examples of the operation object include a slide barobject whose changeable bar object position corresponds to the thresholdvalue.

The communication unit 140 performs communication interface processingfor sending or receiving information with the communication unit 14 ofthe ophthalmologic information processing apparatus 100 under thecontrol of the controller 110.

The controller 110 controls each part of the ophthalmologic informationprocessing apparatus 100. In particular, the controller 110 controls theimage forming unit 120, the data processor 130, and the communicationunit 140. The controller 110 includes the main controller 111 and astorage unit 112. The main controller 111 includes the displaycontroller 111A.

The display controller 111A causes the various information to bedisplayed on the display apparatus 190. For example, the displaycontroller 111A causes the fundus image (front image, tomographic image)of the subject's eye formed by the image forming unit 120 or the imageof the data processing result obtained by the data processor 130 to bedisplayed on the display apparatus 190. Examples of the image of thedata processing result obtained by the data processor 130 include animage representing the geographic atrophy region specified by theanalyzer 200 and an image representing the changed region changed by theregion editing unit 220. In particular, the display controller 111Acauses the fundus image of the subject's eye to be displayed on thedisplay apparatus 190, and causes the region corresponding to thegeographic atrophy region (or changed region, the same applieshereinafter) in the fundus image to be displayed so as to beidentifiable. The display controller 111A according to some embodimentscauses the fundus image of the subject's eye to be displayed on thedisplay apparatus 190, and causes the region corresponding to thegeographic atrophy region in the fundus image to be highlighted. Forexample, the display controller 111A causes the geographic atrophyregion or its background region such that the brightness of the pixelsin the geographic atrophy region or its background region is higher thanthe brightness of the pixels in the other regions to be displayed. Thedisplay controller 111A according to some embodiments causes an image inwhich the image representing the geographic atrophy region performedposition matching by the position matching processor 210 is overlaid onthe fundus image to be displayed.

Further, the display controller 111A causes the morphology informationgenerated by the morphology information generator 204 to be displayed onthe display apparatus 190. The display controller 111A according to someembodiments causes the morphology information generated by themorphology information generator 204 to be displayed on the displayapparatus 190 in association with the geographic atrophy regioncorresponding to the morphology information.

The controller 110 controls each part of the ophthalmologic system 1based on operation instruction signal corresponding to the operationcontent of the user on the operating apparatus 180.

Each of the controller 110, the image forming unit 120, and the dataprocessor 130 includes a processor. The functions of the image formingunit 120 is realized by an image forming processor. The functions of thedata processor 130 is realized by a data processing processor. In someembodiments, at least two functions of the controller 110, the imageforming unit 120, and the data processor 130 are realized by a singleprocessor.

The storage unit 112 stores various kinds of data. Examples of the datastored in the storage unit 112 include data (measurement data,photographic data, etc.) acquired by the ophthalmologic apparatus 10,image data formed by the image forming unit 120, data processingresult(s) obtained by the data processor 130, information related to thesubject and the subject's eye, and the like. The storage unit 112 maystore a variety of computer programs and data for the operation of eachpart of the ophthalmologic information processing apparatus 100.

The operating apparatus 180 is an example of the “operating unit”according to the embodiments. The display apparatus 190 is an example ofthe “display means” according to the embodiments. The geographic atrophyregion is an example of the “lesion region” according to theembodiments.

[Operation Example]

Examples of the operation of the ophthalmologic information processingapparatus 100 according to some embodiments will be described.

FIG. 5 shows an example of the operation of the ophthalmologicinformation processing apparatus 100 according to the embodiments. FIG.5 shows a flowchart of an example of the operation of the ophthalmologicinformation processing apparatus 100. In FIG. 5, it is assumed that thethree-dimensional OCT data of the subject's eye acquired by theophthalmologic apparatus 10 has already stored in the ophthalmologicinformation processing apparatus 100 (storage unit 112).

(S1: Select Subject)

The user selects a subject by inputting the subject ID using theoperating apparatus 180.

(S2: Display Inspection Data)

The storage unit 112 stores a database in which the inspection data ofthe subject is associated in advance corresponding to the subject ID.The controller 110 searches the database using the subject ID input instep S1 as a search key, and acquires the inspection data correspondingto the subject ID. The display controller 111A causes the inspectiondata corresponding to the subject ID acquired by searching the databaseto be displayed on the display apparatus 190. The inspection dataincludes one or more fundus images of the subject's eye acquired in thepast inspection.

(S3: Select Image of Subject's Eye)

The ophthalmologic information processing apparatus 100 causes the userto select the image of the subject's eye to be analyzed among the one ormore images of the subject's eye in the inspection data of the subjectdisplayed on the display apparatus 190 in step S2. The subject operatesthe operating apparatus 180 to select the image of the subject's eye tobe analyzed. The controller 110 receives the operation instructionsignal corresponding to the operation content of the operating apparatus180 by the user.

(S4: Display)

The display controller 111A selects the image of the subject's eyedesignated based on the operation instruction signal input in step S3 tocause the selected image of the subject's eye to be displayed on thedisplay apparatus 190.

(S5: Perform Region Analysis?)

Next, the controller 110 determines whether or not to perform analysisof the geographic atrophy region for the image of the subject's eyedisplayed in step S4. The controller 110 can determine whether or not toperform analysis of the geographic atrophy region based on the operationinstruction signal corresponding to the operation content to instructanalysis execution on the operating apparatus 180.

When it is determined that the analysis of the geographic atrophy regionis to be performed (S5: Y), the operation of the ophthalmologicinformation processing apparatus 100 proceeds to step S6. When it isdetermined that the analysis of the geographic atrophy region is not tobe performed (S5: N), the operation of the ophthalmologic informationprocessing apparatus 100 proceeds to step S9.

(S6: Specify Atrophy Region)

When it is determined that the analysis of the geographic atrophy regionis to be performed in step S5 (S5: Y), the controller 110 controls theanalyzer 200 to specify the geographic atrophy region by performinganalysis of the geographic atrophy region. Details of step S6 will bedescribed later. The controller 110 stores region specificationinformation for specifying a position or a shape of the geographicatrophy region on the fundus in the storage unit 112 in association withthe subject or the subject's eye.

(S7: Perform Analysis of Morphology)

Subsequently, the controller 110 controls the morphology informationgenerator 204 to calculate an area and an outer perimeter of each of thegeographic atrophy regions specified in step S6. The morphologyinformation generator 204 generates the morphology information includingthe total value of the areas of the geographic atrophy regions, thetotal value of the outer perimeters of the geographic atrophy regions,and the number of the specified geographic atrophy regions. Thecontroller 110 stores the morphology information generated in step S7along with the above region specification information in the storageunit 112 in association with the subject or the subject's eye.

The controller 110 according to some embodiments controls the layerthickness distribution information generator 205 to generate thetwo-dimensional distribution information of the layer thickness of eachlayer in the fundus. The controller 110 stores the distributioninformation generated in step S7 along with the above regionspecification information in the storage unit 112 in association withthe subject or the subject's eye.

(S8: Display)

Next, the controller 110 controls the position matching processor 210 toperform position matching between the front image of the fundus formedby the image forming unit 120 in advance and the image representing thegeographic atrophy region specified in step S6. The display controller111A causes the image representing the geographic atrophy regionsuperimposed on the front image of the fundus to be displayed on thedisplay apparatus 190. Here, the front image of the fundus may be ashadowgram ranging from RPE to the Bruch membrane. Further, the displaycontroller 111A causes the morphology information generated in step S7to be displayed on the display apparatus 190 in association with thegeographic atrophy region corresponding to the morphology information.

In the same manner, the controller 110 controls the position matchingprocessor 210 to perform position matching between the tomographic imageformed by the image forming unit 120 in advance and the imagerepresenting the geographic atrophy region specified in step S6. Thedisplay controller 111A causes the image representing the geographicatrophy region superimposed on the tomographic image of the fundus to bedisplayed on the display apparatus 190. Further, the display controller111A causes the morphology information generated in step S7 to bedisplayed on the display apparatus 190 in association with thegeographic atrophy region corresponding to the morphology information.

(S9: Edit Region?)

Next, the controller 110 determines whether or not to edit thegeographic atrophy region specified in step S6. The controller 110 candetermine whether or not to change the geographic atrophy region basedon the operation instruction signal corresponding to the operationcontent for instructing to edit the region on the operating apparatus180.

When it is determined that the geographic atrophy region is to bechanged (S9: Y), the operation of the ophthalmologic informationprocessing apparatus 100 proceeds to step S10. When it is determinedthat the geographic atrophy region is not to be changed (S9: N), theophthalmologic information processing apparatus 100 terminates theoperation (END).

(S10: Edit Atrophy Region)

When it is determined that the geographic atrophy region is to bechanged in step S9 (S9: Y), the controller 110 controls the regionediting unit 220 to perform changing processing of the geographicatrophy region based on the operation instruction signal correspondingto the operation content on the operating apparatus 180 by the user.

For example, as shown in FIG. 6, the region editing unit 220 adds a newgeographic atrophy region R1 by designating a desired region (OP1) forthe front image of the fundus using the operating apparatus 180.

For example, as shown in FIG. 7, the region editing unit 220 deletes ageographic atrophy region R2 from the one or more geographic atrophyregions specified by the analyzer 200 by designating a desired region(0P2) for the front image of the fundus using the operating apparatus180.

The controller 110 stores region specification information forspecifying a position or a shape of the changed region obtained byperforming changing processing in the storage unit 112 in associationwith the subject or the subject's eye.

(S11: Perform region analysis again?)

Subsequently, the controller 110 determines whether or not to performanalysis of the changed region specified in step S10, again. Thecontroller 110 can determine whether or not to perform analysis of thechanged region again based on the operation instruction signalcorresponding to the operation content to instruct re-analysis executionon the operating apparatus 180.

When it is determined that the re-analysis of the changed region is tobe performed (S11: Y), the operation of the ophthalmologic informationprocessing apparatus 100 proceeds to step S12. When it is determinedthat the re-analysis of the changed region is not be performed (S11: N),the ophthalmologic information processing apparatus 100 terminates theoperation (END).

(S12: Perform analysis of morphology)

When it is determined that the re-analysis of the changed region is tobe performed in step S11 (S11: Y), the controller 110 controls themorphology information generator 204 to calculate an area and an outerperimeter of each of the changed regions specified in step S10. Themorphology information generating unit 204 generates morphologyinformation using the in the same manner as step S7. The controller 110stores the morphology information generated in step S12 along with theabove region specification information in the storage unit 112 inassociation with the subject or the subject's eye.

(S13: Display)

Next, the controller 110 controls the position matching processor 210 toperform position matching between the front image of the fundus formedby the image forming unit 120 in advance and the image representing thechanged region specified in step S10. The display controller 111A causesthe image representing the changed region superimposed on the frontimage of the fundus to be displayed on the display apparatus 190. Here,the front image of the fundus may be a shadowgram ranging from RPE tothe Bruch membrane. Further, the display controller 111A causes themorphology information generated in step S12 to be displayed on thedisplay apparatus 190 in association with the changed regioncorresponding to the morphology information.

In the same manner, the controller 110 controls the position matchingprocessor 210 to perform position matching between the tomographic imageof the fundus formed by the image forming unit 120 in advance and theimage representing the changed region specified in step S10. The displaycontroller 111A causes the image representing the changed regionsuperimposed on the tomographic image of the fundus to be displayed onthe display apparatus 190. Further, the display controller 111A causesthe morphology information generated in step S12 to be displayed on thedisplay apparatus 190 in association with the changed regioncorresponding to the morphology information. This terminates theoperation of the ophthalmologic information processing apparatus 100(END).

Next, an example of the operation of step S6 in FIG. 5 will be describedwhile referring to FIGS. 8 to 14.

FIG. 8 shows a flow chart of an example of the operation of step S6 inFIG. 5. FIG. 9 is an operation explanatory diagram for step S22. FIG. 10is an operation explanatory diagram for step S23. FIG. 11A is anoperation explanatory diagram for step S24. FIG. 11B is an operationexplanatory diagram for step S25. FIG. 12 is an operation explanatorydiagram for step S26. FIGS. 13 and 14 are operation explanatory diagramsfor step S27.

(S21: Acquire B scan image)

When it is determined that the analysis of the geographic atrophy regionis to be performed (S5: Y), the controller 110 reads out the data of thefundus of the subject's eye stored in the storage unit 112, and controlsthe image forming unit 120 to form a B scan image based on the readdata. In some embodiments, in step S21, the B scan image is acquiredfrom the ophthalmologic apparatus 10.

(S22: Perform segmentation processing)

The controller 110 controls the segmentation processor 201 to performsegmentation processing on the B scan image acquired in step S21. Thesegmentation processor 201 specifies a plurality of layer regions in theA scan direction for the B scan image acquired in step S21. As shown inFIG. 9, the segmentation processor 201 specifies the inner limitingmembrane 300, the nerve fiber layer, the ganglion cell layer, the innerplexiform layer, the inner nuclear layer, the outer plexiform layer, theouter nuclear layer, the external limiting membrane, the photoreceptorlayer, the RPE 301 which constitute the retina, in the B scan imageIMG1. Further, the segmentation processor 201 specifies, as the Bruchmembrane 302, a layer tissue for a predetermined number of pixels on thesclera side with respect to the specified RPE 301.

(S23: Generate contrast map)

Subsequently, the controller 110 controls the data processor 130 togenerate the contrast map using the result of the segmentationprocessing in step S22. That is, the region specifying unit 202specifies the first region and the second region by analyzing thepartial data sets of the plurality of layer regions specified by thesegmentation processor 201. The first region corresponds to the layertissues on the sclera side from the region corresponding to the Bruchmembrane 302. The second region corresponds to the layer tissues fromthe region corresponding to the inner limiting membrane 300 to theregion corresponding to the RPE 301.

The distribution information generator 203 obtains, as the contrastratio, the ratio of the integrated value of the pixel values in the Ascan direction of the second region to the integrated value of the pixelvalues in the A scan direction of the first region, and generates thetwo-dimensional distribution information of the obtained contrast ratio(FIG. 10).

(S24: Perform smoothing processing)

Next, the controller 110 controls the data processor 130 to performsmoothing processing on the contrast map generated in step S23. Focusingon the fact that the change in pixel value between adjacent pixelsgenerally tends to be small and that the noise component superimposed onthe pixel value is also similar, the contrast map from which the noisecomponent is removed by performing smoothing processing can be obtained(FIG. 11A).

(S25: Perform binarization processing)

Subsequently, the controller 110 controls the data processor 130 toperform binarization processing on the contrast map obtained after thesmoothing processing in step S24. Thereby, a binarized map as shown inFIG. 11B is obtained.

(S26: Search region)

The controller 110 controls the analyzer 200 to search a region byapplying a known region expansion method to the binarized map obtainedin step S25 (FIG. 12).

(S27: Extract contour)

The controller 110 controls the analyzer 200 to extract the contour ofthe region by performing known contour extraction processing on theregion obtained by searching in step S26 (FIG. 13). The analyzer 200specifies the geographic atrophy region based on the extracted contour(FIG. 14). This terminates the processing of step S6 in FIG. 5 (END).

FIG. 15 shows an example of the analysis information displayed on thedisplay apparatus 190 in some embodiments.

For example, in step S8 or step S13, the display controller 111A causesthe image IMGX representing the geographic atrophy region superimposedon the shadowgram (the front image of the fundus) IMG2 to be displayedon the display apparatus 190.

Further, the display controller 111A can cause the morphologyinformation 350 including the total value of the area(s) of thegeographic atrophy region(s), the total value of the outer perimeter(s)of the geographic atrophy region(s), and the number of the geographicatrophy region(s) to be displayed on the display apparatus 190. Thedisplay controller 111A according to some embodiments causes themorphology information of each of the geographic atrophy regions to bedisplayed on the display apparatus 190 in association with thegeographic atrophy region corresponding to the morphology information.Thereby, the morphology of each of the geographic atrophy regions can beobserved in detail.

FIG. 16 shows another example of the analysis information displayed onthe display apparatus 190 in some embodiments.

For example, in step S8 or step S13, the display controller 111A causesthe image IMGY (image of B scan cross section) representing thegeographic atrophy region superimposed on the B scan image IMG3 of thefundus to be displayed on the display apparatus 190. Thereby, themorphology of the geographic atrophy region can be observed in the Bscan image in detail.

Modification Example

The configuration according to some embodiments is not limited to theabove configuration.

First Modification Example

The relative position of the geographic atrophy region with respect tothe macular region (fovea) is effective for the diagnosis of atrophicAMD. The ophthalmologic information processing apparatus according to amodification example of some embodiments analyzes the data of the fundusof the subject's eye acquired by the ophthalmologic apparatus togenerate position information representing a position or a distance ofthe geographic atrophy region with respect to the macular region (fovea)on the fundus.

In the following, the ophthalmologic information processing apparatusaccording to the modification example of the embodiments will bedescribed focusing on differences from the ophthalmologic informationprocessing apparatus according to the above embodiments. The differencebetween the configuration of the ophthalmologic information processingapparatus according to the present modification example and theconfiguration of the ophthalmologic information processing apparatus 100described above is the analyzer.

FIG. 17 shows a block diagram of an example of the configuration of theanalyzer 200 a according to the modification example of the embodiments.In FIG. 17, parts similar to those in FIG. 4 are denoted by the samereference symbols, and description thereof is omitted as appropriate.

In the present modification example, an analyzer 200 a according to themodification example shown in FIG. 17 is provided instead of theanalyzer 200 in the data processor 130 shown in FIG. 3. The analyzer 200a differs from the analyzer 200 in that a position information generator206 a is added to the analyzer 200.

The analyzer 200 a specifies a region corresponding to the fovea byanalyzing three-dimensional OCT data of the subject's eye using a knownmethod, and specifies a region having a predetermined radius around thefovea as the macular region.

The position information generator 206 a generates the positioninformation. The position information represents a relative position ofa representative position of the geographic atrophy region with respectto a representative position of the macular region specified by theanalyzer 200 a, position information representing a distance betweenboth the representative positions, vector information indicating amovement direction or a movement distance of the representative positionof the geographic atrophy region in a predetermined period, or vectorinformation indicating a movement direction or a movement distance ofthe representative position of the geographic atrophy region withrespect to the representative position of the macular region in apredetermined period. Examples of the representative position of themacular region include a position of the fovea, a position of the centerof gravity of the macular region, the closest (or farthest) position tothe geographic atrophy region in the outline of the macular region, andthe like. Examples of the representative position of the geographicatrophy region include a center position of the geographic atrophyregion, a position of the center of gravity of the geographic atrophyregion, the closest (or farthest) position to the macular region (or thefovea) in the outline of the geographic atrophy region, and the like.The display controller 111A according to the modification example ofsome embodiments causes the position information, which is generated bythe position information generator 206 a, to be displayed on the displayapparatus 190 in association with the geographic atrophy regioncorresponding to the position information.

FIG. 18 shows an example of the analysis information displayed on thedisplay apparatus 190 in the modification example of the embodiments.

For example, the display controller 111A causes the image IMGXrepresenting the geographic atrophy region and the image IMGZrepresenting the position (range) of the macular region specified by theanalyzer 200 a superimposed on the shadowgram (the front image of thefundus) IMG2 to be displayed on the display apparatus 190. The imageIMGZ may be an image representing a position of the fovea.

Further, the display controller 111A can cause the position informationrepresenting the relative position of the geographic atrophy region withrespect to the macular region, in addition to the morphology informationincluding the total value of the area(s) of the geographic atrophyregion(s), the total value of the outer perimeter(s) of the geographicatrophy region(s), or the number of the geographic atrophy region(s) tobe displayed on the display apparatus 190. The display controller 111Aaccording to some embodiments causes the position information of each ofthe geographic atrophy regions to be displayed on the display apparatus190 in association with the geographic atrophy region corresponding tothe position information. Thereby, the position of each of thegeographic atrophy regions can be observed in detail.

FIG. 19 shows another example of the analysis information displayed onthe display apparatus 190 in the modification example of theembodiments.

For example, the display controller 111A causes the image IMGY (image ofB scan cross section) representing the geographic atrophy region and theimage IMGZ1 representing the position (range) of the macular regionspecified by the analyzer 200 a superimposed on the B scan image IMG3 ofthe fundus to be displayed on the display apparatus 190. Thereby, theposition of geographic atrophy region with respect of the macular regioncan be observed in the B scan image in detail.

Second Modification Example

In some embodiments, a new geographic atrophy region is specified bynewly analyzing the changed region specified by the region editing unit220, and morphology information, position information, or the like ofthe specified geographic atrophy region is obtained.

In the following, the ophthalmologic information processing apparatusaccording to the modification example of the embodiments will bedescribed focusing on differences from the ophthalmologic informationprocessing apparatus according to the above embodiments. The differencebetween the ophthalmologic information processing apparatus according tothe present modification example and the ophthalmologic informationprocessing apparatus 100 described above is the operation contentexecuted by the controller 110 and the data processor 130.

FIG. 20 shows an example of the operation of the ophthalmologicinformation apparatus according to the modification example of theembodiments. FIG. 20 shows a flow chart of an operation example of theophthalmologic information apparatus according to the presentmodification example. In FIG. 20, like reference numerals designate likeparts as in FIG. 5, and the same description may not be repeated.

In the present modification example, steps S1 to S11 are the same asthose in FIG. 5.

(S31: Change analysis condition)

When it is determined that the re-analysis of the changed region is tobe performed (S11: Y), the controller 110 sets the second analysiscondition different from the first analysis condition used in theprocess of specifying the geographic atrophy region in step S6. In someembodiments, the second analysis condition is an analysis condition fornewly specifying a geographic atrophy region which has not beenspecified under the first analysis condition (an analysis condition inwhich the detection sensitivity (specification sensitivity) of thegeographic atrophy region is higher than the first analysis condition).

(S32: Specify atrophy region)

Next, the controller 110 controls the analyzer 200 to specify the newgeographic atrophy region by performing analysis of the changed region.Step S32 is the same as step S6. The controller 110 stores regionspecification information for specifying a position and a shape of thenew geographic atrophy region on the fundus in the storage unit 112 inassociation with the subject or the subject's eye.

(S33: Perform analysis of morphology)

Subsequently, the controller 110 controls the morphology informationgenerator 204 to calculate an area and an outer perimeter of each of thenew geographic atrophy regions specified in step S32. The morphologyinformation generating unit 204 generates morphology information, in thesame manner as step S7. The controller 110 stores the morphologyinformation generated in step S33 along with the above regionspecification information in the storage unit 112 in association withthe subject or the subject's eye.

(S34: Display)

Next, the controller 110 controls the position matching processor 210 toperform position matching between the front image of the fundus formedby the image forming unit 120 in advance and the image representing thegeographic atrophy region specified newly in step S32. The displaycontroller 111A causes the image representing the geographic atrophyregion superimposed on the front image of the fundus to be displayed onthe display apparatus 190. Here, the front image of the fundus may be ashadowgram ranging from RPE to the Bruch membrane. Further, the displaycontroller 111A causes the morphology information generated in step S33to be displayed on the display apparatus 190 in association with thegeographic atrophy region corresponding to the morphology information.

In the same manner, the controller 110 controls the position matchingprocessor 210 to perform position matching between the tomographic imageof the fundus formed by the image forming unit 120 in advance and theimage representing the geographic atrophy region specified newly in stepS32. The display controller 111A causes the image representing thegeographic atrophy region superimposed on the tomographic image of thefundus to be displayed on the display apparatus 190. Further, thedisplay controller 111A causes the morphology information generated instep S33 to be displayed on the display apparatus 190 in associationwith the geographic atrophy region corresponding to the morphologyinformation. This terminates the operation of the ophthalmologicinformation processing apparatus 100 (END).

Third Modification Example

The ophthalmologic apparatus according to some embodiments has at leastone of the function of the ophthalmologic information processingapparatus 100, the function of the operating apparatus 180, and thefunction of the display apparatus 190, in addition to the function ofthe ophthalmologic apparatus 10.

In the following, the ophthalmologic apparatus according to amodification example of some embodiments will be described focusing ondifferences from the ophthalmologic apparatus according to the aboveembodiments.

FIG. 21 shows a block diagram of an example of the configuration of theophthalmologic apparatus 10 b according to the modification example ofthe embodiments. In FIG. 21, components similar to those in FIG. 2 aregiven the same reference numerals. The description of such components isbasically omitted.

The difference between the configuration of the ophthalmologic apparatus10 b according to the present modification example and the configurationof ophthalmologic apparatus 10 according to the above embodiments isthat the ophthalmologic apparatus 10 b has the function of theophthalmologic information processing apparatus 100, the function of theoperating apparatus 180, and the function of the display apparatus 190.The ophthalmologic apparatus 10 b includes a controller 11 b, the dataacquisition unit 12, the image forming unit 13, an ophthalmologicinformation processor 15 b, an operating unit 16 b, and a display unit17 b.

The controller 11 b controls each part of the ophthalmologic apparatus10 b. In particular, the controller 11 b controls the data acquisitionunit 12, the image forming unit 13, the ophthalmologic informationprocessor 15 b, the operating unit 16 b, and the display unit 17 b.

The ophthalmologic information processor 15 b has the same configurationas the ophthalmologic information processing apparatus 100, and has thesame function as the ophthalmologic information processing apparatus100. The operating unit 16 b has the same configuration as the operatingapparatus 180, and has the same function as the operating apparatus 180.The display unit 17 b has the same configuration as the displayapparatus 190, and has the same function as the display apparatus 190.

According to the present modification example, an ophthalmologicapparatus capable of observing in detail the morphology and thedistribution of the geographic atrophy region in a compact configurationcan be provided.

Effects

Hereinafter, the effects of the ophthalmologic information processingapparatus, the ophthalmologic system, the ophthalmologic informationprocessing method, and the program according to some embodiments will bedescribed.

An ophthalmologic information processing apparatus (100) according tosome embodiments includes an analyzer (200, 200 a), a storage unit(112), a region editing unit (220), and a display controller (111A). Theanalyzer is configured to analyze data of a subject's eye opticallyacquired by projecting light onto the subject's eye, and to specify alesion region (geographic atrophy region) in the subject's eye. Thestorage unit stores image data of the subject's eye. The region editingunit is configured to specify a changed region by changing the lesionregion based on operation information corresponding to an operationcontent on an operating unit (operating apparatus 180). The displaycontroller is configured to cause an image of the subject's eye to bedisplayed on a display means based on the image data stored in thestorage unit, and to cause a region corresponding to the changed regionin the image of the subject's eye to be displayed so as to beidentifiable.

According to such a configuration, the changed region is specified bychanging the lesion region specified by analyzing the data of thesubject's eye acquired optically, the fundus image of the subject's eyeis displayed on the display means, and the changed region in the fundusimage is displayed so as to be identifiable. Therefore, the morphologyor the distribution of the changed region can be grasped in detail evenwhen the detection accuracy of the lesion region is not sufficient.Thereby, doctors or the like can make accurate diagnosis for patients.

In the ophthalmologic information processing apparatus according to someembodiments, the region editing unit is configured to specify thechanged region by changing a shape of the lesion region based on theoperation information.

According to such a configuration, a doctor or the like can change theshape of the specified lesion region while referring to informationobtained from another ophthalmologic apparatus, and can observe themorphology or the distribution of the lesion region in detail from theobtained changed region.

In the ophthalmologic information processing apparatus according to someembodiments, the region editing unit is configured to specify thechanged region by adding a regions designated based on the operationinformation to the lesion region.

According to such a configuration, a doctor or the like can add a newlesion region to the specified lesion region while referring toinformation obtained from another ophthalmologic apparatus, and themorphology or the distribution of the lesion region can be observed indetail from the obtained changed region.

In the ophthalmologic information processing apparatus according to someembodiments, the region editing unit is configured to specify thechanged region by deleting a region designated based on the operationinformation from the lesion region.

According to such a configuration, a doctor or the like can delete atleast a part of the specified lesion region while referring toinformation obtained from another ophthalmologic apparatus, and canobserve the morphology or the distribution of the lesion region indetail from the obtained changed region.

In the ophthalmologic information processing apparatus according to someembodiments, the analyzer is configured to newly specify the lesionregion in the subject's eye by performing an analysis again, in whichanalysis conditions have been changed, on the changed region changed bythe region editing unit. The display controller is configured to cause aregion corresponding to the lesion region newly specified by performingthe analysis again by the analyzer to be displayed on the display meansso as to be identifiable.

According to such a configuration, the ophthalmologic informationprocessing apparatus capable of newly specifying a lesion region for adesired region and of grasping the morphology or the distribution of thespecified new lesion region in detail can be provided.

In the ophthalmologic information processing apparatus according to someembodiments, the analyzer is configured to specify a new lesion regionby specifying the lesion region under a first analysis condition andanalyzing the changed region under a second analysis condition differentfrom the first analysis condition.

According to such a configuration, by repeating the process ofspecifying he lesion region for the desired region alone, the lesionregion can be newly specified and the morphology or the distribution ofthe lesion region specified newly can be observed in detail.

In the ophthalmologic information processing apparatus according to someembodiments, the data of the subject's eye is data of a fundus of thesubject's eye. The analyzer includes a segmentation processor (201) anda distribution information generator (203). The segmentation processoris configured to specify a plurality of layer regions in an A scandirection based on the data. The distribution information generator isconfigured to generate distribution information on ratio (contrast map)between integrated values of pixel values in the A scan direction of thelayer regions located on a sclera side with reference to a Bruchmembrane and integrated values of pixel values in the A scan directionof the layer regions located on a cornea side with reference to theBruch membrane, the layer regions being specified by the segmentationprocessor. The analyzer is configured to specify the lesion region basedon the distribution information.

According to such a configuration, the lesion region is specified fromthe data acquired using optical coherence tomography and changed regionobtained by changing the specified lesion region is displayed so as tobe identifiable. Thereby, the morphology or the distribution of thelesion region can be observed in detail while reducing the burden on thesubject.

The ophthalmologic information processing apparatus according to someembodiments includes a position matching processor (210). The positionmatching processor is configured to perform position matching between afundus image of the subject's eye and an image representing the changedregion specified based on the distribution information. The displaycontroller is configured to cause the image representing the changedregion, which has been performed position matching by the positionmatching processor, to be laid on the fundus image and to be displayed.

According to such a configuration, the image representing the changedregion obtained by changing the specified lesion region is laid on thefundus image and is displayed. Thereby, the morphology or thedistribution of the lesion region can be easily grasped.

An ophthalmologic system according to some embodiments includes a dataacquisition unit (12) configured to acquire the data by scanning thesubject's eye using optical coherence tomography; the display means; andthe ophthalmologic information processing apparatus described in any oneof the above.

According to such a configuration, the changed region is specified bychanging the lesion region specified by analyzing the data of thesubject's eye, and the changed region in the fundus image is displayedso as to be identifiable. Thereby, the morphology or the distribution ofthe changed region can be grasped in detail and a doctor or the like canmake accurate diagnosis for patients, even when the detection accuracyof the lesion region is not sufficient.

An ophthalmologic information processing method includes an analysisstep, a region editing step, and a display step. The analysis step isperformed to analyze data of a subject's eye optically acquired byprojecting light onto the subject's eye, and of specifying a lesionregion (geographic atrophy region) in the subject's eye. The regionediting step is performed to specify a changed region by changing thelesion region based on operation information corresponding to anoperation content on an operating unit (operating apparatus 180). Thedisplay step is performed to cause an image of the subject's eye to bedisplayed on a display means (display apparatus 190) based on image dataof the subject's eye, and to cause a region corresponding to the changedregion in the image of the subject's eye to be displayed so as to beidentifiable.

According to such a configuration, the changed region is specified bychanging the lesion region specified by analyzing the data of thesubject's eye acquired optically, the fundus image of the subject's eyeis displayed on the display means, and the changed region in the fundusimage is displayed so as to be identifiable. Therefore, the morphologyor the distribution of the changed region can be grasped in detail evenwhen the detection accuracy of the lesion region is not sufficient.Thereby, doctors or the like can make accurate diagnosis for patients.

In the ophthalmologic information processing method according to someembodiments, the region editing step is performed to specify the changedregion by changing a shape of the lesion region based on the operationinformation.

According to such a configuration, a doctor or the like can change theshape of the specified lesion region while referring to informationobtained from another ophthalmologic apparatus, and can observe themorphology or the distribution of the lesion region in detail from theobtained changed region.

In the ophthalmologic information processing method according to someembodiments, the region editing step to specify changed region by addinga region designated based on the operation information to lesion region.

According to such a configuration, a doctor or the like can add a newlesion region to the specified lesion region while referring toinformation obtained from another ophthalmologic apparatus, and themorphology or the distribution of the lesion region can be observed indetail from the obtained changed region.

In the ophthalmologic information processing method according to someembodiments, the region editing step is performed to specify the changedregion by deleting a region designated based on the operationinformation from the lesion region.

According to such a configuration, a doctor or the like can delete atleast a part of the specified lesion region while referring toinformation obtained from another ophthalmologic apparatus, and canobserve the morphology or the distribution of the lesion region indetail from the obtained changed region.

In the ophthalmologic information processing method according to someembodiments, the analysis step is performed to newly specify the lesionregion in the subject's eye by performing an analysis again, in whichanalysis conditions have been changed, on the changed region changed inthe region editing step. The display step is performed to cause a regioncorresponding to the lesion region newly specified by performing theanalysis again in the analysis step to be displayed on the display meansso as to be identifiable.

According to such a configuration, a lesion region can be newlyspecified for a desired region and the morphology or the distribution ofthe specified new lesion region can be grasped in detail.

A program according to some embodiments causes a computer to executeeach step of the ophthalmologic information processing method describedin any of the above.

According to such a configuration, the changed region is specified bychanging the lesion region specified by analyzing the data of thesubject's eye, and the changed region in the fundus image is displayedso as to be identifiable. Therefore, the program for grasping themorphology or the distribution of the changed region in detail can beprovided even when the detection accuracy of the lesion region is notsufficient.

A program for realizing the ophthalmologic information processing methodaccording to some embodiments can be stored in any kind of computernon-transitory recording medium. The recording medium may be anelectronic medium using magnetism, light, magneto-optical,semiconductor, or the like. Typically, the recording medium is amagnetic tape, a magnetic disk, an optical disk, a magneto-optical disk,a flash memory, a solid state drive, or the like.

The computer program may be transmitted and received through a networksuch as the Internet, LAN, etc.

Configurations described above are merely examples for preferablyimplementing the present invention. One who intends to implement thepresent invention may arbitrarily modify (omission, replacement,addition, etc.) within the scope of the invention.

The invention has been described in detail with particular reference topreferred embodiments thereof and examples, but it will be understoodthat variations and modifications can be effected within the spirit andscope of the invention covered by the claims which may include thephrase “at least one of A, B and C” as an alternative expression thatmeans one or more of A, B and C may be used, contrary to the holding inSuperguide v. DIRECTV, 69 USPQ2d 1865 (Fed. Cir. 2004).

While certain embodiments have been described, these embodiments havebeen presented by way of example only, and are not intended to limit thescope of the inventions. Indeed, the novel embodiments described hereinmay be embodied in a variety of other forms; furthermore, variousomissions, substitutions and changes in the form of the embodimentsdescribed herein may be made without departing from the spirit of theinventions. The accompanying claims and their equivalents are intendedto cover such forms or modifications as would fall within the scope andspirit of the inventions.

What is claimed is:
 1. An ophthalmologic information processingapparatus, comprising: an analyzer configured to analyze data of asubject's eye optically acquired by projecting light onto the subject'seye, and to specify a lesion region in the subject's eye; a storage unitstoring image data of the subject's eye; a region editing unitconfigured to specify a changed region by changing the lesion regionbased on operation information corresponding to an operation content onan operating unit; and a display controller configured to cause an imageof the subject's eye to be displayed on a display means based on theimage data stored in the storage unit, and to cause a regioncorresponding to the changed region in the image of the subject's eye tobe displayed so as to be identifiable.
 2. The ophthalmologic informationprocessing apparatus of claim 1, wherein the region editing unit isconfigured to specify the changed region by changing a shape of thelesion region based on the operation information.
 3. The ophthalmologicinformation processing apparatus of claim 1, wherein the region editingunit is configured to specify the changed region by adding a regiondesignated based on the operation information to the lesion region. 4.The ophthalmologic information processing apparatus of claim 1, whereinthe region editing unit is configured to specify the changed region bydeleting a region designated based on the operation information from thelesion region.
 5. The ophthalmologic information processing apparatus ofclaim 1, wherein the analyzer is configured to newly specify the lesionregion in the subject's eye by performing an analysis again, in whichanalysis conditions have been changed, on the changed region changed bythe region editing unit, and the display controller is configured tocause a region corresponding to the lesion region newly specified byperforming the analysis again by the analyzer to be displayed on thedisplay means so as to be identifiable.
 6. The ophthalmologicinformation processing apparatus of claim 5, wherein the analyzer isconfigured to specify a new lesion region by specifying the lesionregion under a first analysis condition and analyzing the changed regionunder a second analysis condition different from the first analysiscondition.
 7. The ophthalmologic information processing apparatus ofclaim 5, wherein the data of the subject's eye is data of a fundus ofthe subject's eye, and the analyzer includes: a segmentation processorconfigured to specify a plurality of layer regions in an A scandirection based on the data, and a distribution information generatorconfigured to generate distribution information on ratio betweenintegrated values of pixel values in the A scan direction of the layerregions located on a sclera side with reference to a Bruch membrane andintegrated values of pixel values in the A scan direction of the layerregions located on a cornea side with reference to the Bruch membrane,the layer regions being specified by the segmentation processor, and theanalyzer is configured to specify the lesion region based on thedistribution information.
 8. The ophthalmologic information processingapparatus of claim 7, further comprising a position matching processorconfigured to perform position matching between a fundus image of thesubject's eye and an image representing the changed region specifiedbased on the distribution information, wherein the display controller isconfigured to cause the image representing the changed region, which hasbeen performed position matching by the position matching processor, tobe laid on the fundus image and to be displayed.
 9. An ophthalmologicsystem, comprising: a data acquisition unit configured to acquire thedata by scanning the subject's eye using optical coherence tomography;the display means; and the ophthalmologic information processingapparatus described in claim
 1. 10. An ophthalmologic informationprocessing method, comprising: an analysis step of analyzing data of asubject's eye optically acquired by projecting light onto the subject'seye, and of specifying a lesion region in the subject's eye; a regionediting step of specifying a changed region by changing the lesionregion based on operation information corresponding to an operationcontent on an operating unit; and a display step of causing an image ofthe subject's eye to be displayed on a display means based on image dataof the subject's eye, and of causing a region corresponding to thechanged region in the image of the subject's eye to be displayed so asto be identifiable.
 11. The ophthalmologic information processing methodof claim 10, wherein the region editing step is performed to specify thechanged region by changing a shape of the lesion region based on theoperation information.
 12. The ophthalmologic information processingmethod of claim 10, wherein the region editing step is performed tospecify the changed region by adding a region designated based on theoperation information to the lesion region.
 13. The ophthalmologicinformation processing method of claim 10, wherein the region editingstep is performed to specify the changed region by deleting a regiondesignated based on the operation information from the lesion region.14. The ophthalmologic information processing method of claim 10,wherein the analysis step is performed to newly specify the lesionregion in the subject's eye by performing an analysis again, in whichanalysis conditions have been changed, on the changed region changed inthe region editing step, and the display step is performed to cause aregion corresponding to the lesion region newly specified by performingthe analysis again in the analysis step to be displayed on the displaymeans so as to be identifiable.
 15. A non-transitory computer readablerecording medium storing a program of causing a computer to execute eachstep of the ophthalmologic information processing method according toclaim 10.